JOB SUMMARY

The Provider Data Specialist will be responsible for entering and maintaining large amounts of provider demographic and credentialing data from various sources into the company’s provider database and maintaining the accuracy and currentness of the data. Other supportive assignments will be assigned as identified such as audits and special projects.  

ESSENTIAL DUTIES AND RESPONSIBILITIES

This position must be able to:

• Ensure the accuracy and integrity of provider demographic and contract affiliation information within the Plan’s system

• Exhibit meticulous attention to detail, accuracy and efficiency in processing incoming requests for provider and facility network additions, terminations and changes

• Receive and process provider information from external sources for system updates by applying your knowledge and experience to validate the provided information

• Regular audits of loaded provider records are conducted to ensure both quality and financial accuracy, with documented feedback provided when necessary

• Resolves minor processing problems; seeks assistance from supervisor for issues beyond immediate expertise.

• Maintains confidentiality of sensitive information.

• Identify, locate, and correct data entry errors or report them to supervisors.

• Compile, sort, and verify the accuracy of data before it is entered.

• Compare data with source documents, or re-enter data in verification format to detect errors.

• Store completed documents in appropriate locations.

EDUCATION AND EXPERIENCE

Education:

• Associates degree or higher preferred.

• High school diploma or equivalent required.

Required Experience:

• Minimum typing skill of 45 words per minute (wpm)

• Proficient use of computers and computer systems to enter data, or process transactions.

• Proficient user of all Microsoft products, specifically Excel, Word, and Outlook.

• Prior data entry experience

• Ability to compile and format data and produce associated reports

Preferred Experience:

• Prior provider data entry experience

• Prior health plan experience

• Processing delegated practitioner rosters for network additions, terminations and changes

Other Requirements:

• Annual Flu Vaccine

KNOWLEDGE, SKILLS, AND ABILITIES

Required Competencies:

• Excellent keyboarding skills, including speed, efficiency and accuracy

• High level of concentration, patience, and the ability to silence distractions is crucial to avoid mistakes.

• Ability to research, collect data and organize the data in a straightforward manner.

• Critical thinking with the ability to analyze information and make reasoned decisions objectively while spotting any inconsistencies and maintaining data integrity.

• High level of attention to detail and accuracy

• Excellent time management and organizational skills to be able to prioritize, plan, and execute on tasks ensuring the work is completed by required deadline.

• Resilience and stress management working with large amounts of data with tight deadlines

• Experience and ability to use Microsoft Office products and word-processing software daily.

• Solid written, verbal, and listening communication abilities. Communicates appropriately and clearly to members, coworkers, and providers to ensure a productive conversation.

• Ability to exercise discretion and good judgment keeping all types of data confidential so as not to disclose sensitive information.

PHYSICAL REQUIREMENTS

• Prolonged periods of sitting at a desk and working on a computer.

Benefits from Day One: 

• Medical, Dental, and Vision Coverage
• 401(k) Retirement Plan with Company Match
• Paid Time Off (PTO) and Volunteer Time Off (VTO)
• Paid Company Holidays
• Health Savings Account (HSA) and Flexible Spending Account (FSA) Options
• Long-Term and Short-Term Disability Coverage
• Employee Assistance Program (EAP) for Personal and Professional Support
• Tuition Assistance for Continued Education
• Pet Insurance for Your Furry Family Members
• Ongoing Professional Development and Training Opportunities
• And an array of additional benefits designed with you in mind.

ABOUT HEALTHTEAM ADVANTAGE

HEALTHTEAM ADVANTAGE is an equal-opportunity employer. All applicants are considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

HealthTeam Advantage (HTA), a Greensboro-based health insurance company, offers Medicare Advantage plans to eligible Medicare beneficiaries in 33 North Carolina counties. HTA has been named a “Best Places to Work” finalist three times by Triad Business Journal. To learn more, visit HealthTeamAdvantage.com